Life Never Goes As Planned
by DarkandtwistyGirl
Summary: Set mid-season 12. This is not what Ray had planned, far from it. He never expected that a simple fall would lead to a terminal diagnosis, ALS. *Complete*
1. Chapter 1

**Disclaimer: I don't own ER, or any characters you recognise.**

**Hi all! This is the first ER fic I've written that I think is fit to be posted; by no means my first ER fic. *lol***

**Just to make this clear - ****I have no medical knowledge, just way too much time to search the internet. Sorry for any inacuracies.**

**Enjoy!**

* * *

It is just before dawn on a Tuesday, there is a fine dusting a snow covering the ground outside the ER, and Ray has been on shift for almost twelve hours.

He is rushing to attend to one of his patients when Ray feels himself stumble, and is unable to stop his inevitable fall. He lands with a thud, right at Weaver's feet.

"Barnett?!" Weaver exclaims in surprise as she looks down at him.

Ray lies on the ground, shocked for a moment. He then he reaches out to Kerry, and says. "Can you give me a hand?"

Weaver takes Ray's hand, and helps him pull himself to his feet. She then questions him. "What happened Barnett?"

As Ray brushes himself off, he answers. "Nothing, I tripped." He then steps away from her, and moves towards exam 2, as he tells Weaver. "I've got to get back to my patient."

Before Kerry can say anything, Ray walks away, and all she can do is get back to work. _That was odd._

* * *

Two and a half weeks later. Ray, Weaver, and Sam are working on a trauma patient, a teenage boy shot in a crossfire.

Ray moves to intubate, and just as Sam hands him the tube, his hand cramps up, causing him to drop the tube. "Damn it!" He exclaims with frustration. _What the hell is happening to me?!_

Sam looks at him questioningly, as she says. "Sorry, it was my fault. I'll get another kit." She then goes to retrieve the intubation kit.

While Sam is looking for the kit, in a hushed voice, Weaver asks Ray. "What's going on?"

"…" Ray hesitates before he answers. "I don't know."

The undertone of fear in Ray's voice leads Weaver to tell him, much more gently than she usually would. "We can handle this. Go sit in sutures, I'll be in soon."

Ray simply nods as he steps away from the gurney, and walks through the door into the suture room.

He sits down tiredly on the gurney, and takes his right hand in his left, and rubs it, trying to ease the cramped muscle.

* * *

By the time Weaver enters the room ten minutes later, the cramp hasn't subsided, and Ray is lying back against the gurney, his face showing his pain clearly.

Knowing that he must hate this situation, Weaver forces herself to treat him like any other patient. She has already drawn up a dose of clonazepam to treat the cramp. Weaver puts the tray she is carrying on the gurney, and asks Ray. "You don't have any allergies, do you?"

"None." Ray replies simply, then looking at the needle with caution, he asks. "What's that?"

"Clonazepam, it should stop the cramping. Then we'll work out what's causing it." Kerry tells him as she rubs an alcohol swab over Ray's bicep, and then picks up the needle.

Just as she goes to inject the medication, Ray stops her, and says. "I hate needles."

"Just look the other way, I'll do it as quickly as possible."

Ray hesitates, but after a moment, he turns his head away, and within a second, he feels the sharp sting of the needle entering his arm.

"Okay, all done." Kerry declares, she then goes about cleaning away the medical equipment while they wait for the medication to take effect.

* * *

Within five minutes, the medication begins to work, and Ray can relax. Kerry wastes no time before asking him. "How long have you been having these muscle cramps?"

"…Maybe a week."

"Any other symptoms?"

Ray thinks for a moment before he answers. "Some weakness in my legs, I keep tripping over my own feet, and I sometimes can't hold onto stuff." When he says it aloud, he knows that he was stupid not to see someone before now.

Weaver grabs a note pad from a nearby counter, and jots this down before saying. "I want to do some tests …Do you want me to go get one of the nurses to start a chart, and admit you here? Or set up for you to go to the outpatient clinic?"

"Outpatient." Ray answers without pause, he then asks. "What sort of tests are you thinking?"

"Routine labs, EMG, MRI, lumbar puncture, maybe more." Kerry tells him quickly.

Ray knows that she must have an idea what is going on to be ordering this range of tests, so he asks. "You think I've got something major, don't you?"

"…" Kerry's hesitation says it all for Ray, but still a moment later, she confirms his fears. "It could be nothing, and you know that without the tests I'm just guessing, but… the symptoms suggest a number of conditions. Tumour, MS, CNS infection, ALS."

Before Ray can respond, there is a knock on the door, and Abby walks in. "Sorry to interrupt, Dr Weaver. Your patient in curtain 3 isn't looking good."

Weaver quickly moves towards the door, as she reaches the doorway, she turns back to look at Ray, and says. "Come to my office after your shift."

Ray can only nod as Kerry hurries from the room, leaving him to his thoughts.

_A tumour?!_

_MS?!_

_Infection in the brain?!_

_ALS?!_

_This can't be happening!_

He has given many people these diagnoses before without pause, not even thinking about what they will face, but now-

_Surgery._

_Endless meds._

_Long hospital stays._

_Neurological degeneration._

_Pain._

_Death._

* * *

**Should I continue this fic?**

**Please let me know what you think!**


	2. Chapter 2

**Disclaimer: I don't own ER, or any characters you recognise.**

**Hi all! Thank you some much for the amazing response to the first chapter of this fic!**

**Just to make this clear - ****I have no medical knowledge, just way too much time to search the internet. Sorry for any inaccuracies.**

**Enjoy!**

* * *

That evening, when Ray finishes his shift, instead of going up to Weaver's office, he goes to the roof, and leans on the edge.

_I can't be sick, this can't be happening._

_It has to be nothing._

_I don't need all those tests to prove to me that it's nothing._

* * *

Ray is still in the same position when Weaver finds him up there half an hour later. She walks over to him, and firmly, but comfortingly says. "Come inside, Ray."

"I don't need tests. I'm not sick." Ray mumbles, obviously more to convince himself than her. All his medical training tells him that he is probably sick, and that he does need tests, but he is terrified of what the tests might show.

Kerry knows that he needs time to think, so she simply tells him. "I'll be in my office 'til late." And then walks back to the fire escape door, and goes inside.

Within a few minutes Ray follows her. _Might as well get this over with._

* * *

The tests are scheduled for three days later, Monday. And Ray shows up at the outpatient department first thing that morning, as instructed.

He goes over to the reception desk where an attractive woman, about the same age as him greets him. "Hi, I'm Kelsey. How can I help you?"

"I'm meant to have some tests today …Full blood workup, MRI, EMG, muscle biopsy, and a lumbar puncture. Name's Ray Barnett."

Kelsey looks down at her computer, and quickly types something in, then looks back up at Ray. "Alright Ray, if you'll just take a seat, someone will be with you shortly."

"Thanks." Ray replies, forcing a smile before walking over to the small waiting area, and sitting down on one of the plastic chairs.

* * *

A week later, Weaver is working in her office when there is a knock on the door. She calls out. "Come in."

The door opens, and her assistant walks into the office, carrying an envelope. "Dr Weaver, these test results were just brought up from the lab. The tech said to hand them to you directly, said something about a VIP patient-"

Kerry doesn't need to hear anymore, she knows what this is, so she interrupts as she stands up, and walks over to her assistant. "Thank you, Tom. I'll take those now."

Tom hands over the envelope, and then asks. "Should I hold your calls?"

"Yes, thank you." Kerry replies as she sits back down behind her desk, and gives Tom a look that clearly says 'leave'.

* * *

Once she is alone, Kerry rips open the envelope, and pulls out the printed pages it contains. She puts the papers down on her desk, and puts on her glasses before starting to read.

As she reads through the papers, her expression turns from professional to concerned, and then as Kerry finishes the last page, she has to struggle to maintain some small measure of her composure, as she blinks back tears.

She might not be close to Ray, but she knows that he is a decent guy, and a good doctor, and he definitely doesn't deserve this.

The test results conclusively show that Ray has amyotrophic lateral sclerosis, ALS.

* * *

Meanwhile downstairs in the ER, Ray is standing out in the ambulance bay waiting for an ambulance with Abby, when Luka comes out into the bay, and calls out to Ray. "Ray. Weaver called, she needs to see you in her office, now."

Ray knows that the test results should be back today, and he has been waiting anxiously all day. But Ray masks his nervousness before he turns around to face Luka, and lightly says. "Okay. Can you take this trauma?"

"Sure."

Ray nods to Luka in acknowledgement as he strides inside.

"What was that about?" Abby enquires to Luka once Ray is out of sight.

Luka recalls how vague Kerry had been on the phone before he answers. "I don't know. Weaver just said to send Ray up to her office, and not to expect him back today."

* * *

Five minutes later, Ray enters Weaver's office just as she is wiping away a stray tear. He immediately knows that it is not going to be good.

Kerry looks up from her desk, but before she can greet Ray, he questions her. "So what is it?"

"…" Kerry hesitates. "You should sit down, Ray."

Ray stays where he is, and insistently says. "I'm fine here." Actually he is exhausted, and can tell that he won't be able to stay standing much longer, but still- "Tell me what the tests showed."

Kerry sighs as she sadly informs Ray. "You have ALS. I'm sorry, Ray."

Upon hearing this, Ray just looks stunned.

_This can't be happening! _

_I'm not even that sick._

Eventually the sound of Kerry's voice breaks into his thoughts. "…called Nina Cohen, she's a neurologist over at Northwestern, specialises in motor neuron diseases."

"What?" Ray looks up at Weaver, and it is clear to her that he hasn't heard anything.

Kerry takes a deep breath before repeating herself. "I've called Nina Cohen, a motor neuron disease specialist over at Northwestern, one of the best in the country. She has agreed to take your case. You have an appointment with her on Thursday."

Ray begins to sway on his feet, and unsteadily collapses into the previously offered seat. As he buries his head in his hands, Ray murmurs. "This can't be happening. I don't want to die."

* * *

**TBC...**

**Please let me know what you think!**


	3. Chapter 3

**Disclaimer: I don't own ER, or any characters you recognise.**

**Hi all! Thank you some much for all the wonderful reviews!**

**Just to make this clear - ****I have no medical knowledge, just way too much time to search the internet. Sorry for any inaccuracies.**

**Enjoy!**

* * *

Despite Kerry's advice, Ray returns to work as soon as they finish their meeting. He isn't any worse off than he was an hour ago, so why should he go home early?

"Ray." Luka calls out to Ray as he grabs a chart, and strides towards one of the exam rooms. "Wait for a minute."

Ray stops, and turns around to Luka. And pretending that everything is alright, and he hasn't just been diagnosed with a terminal illness, he says. "What's up?"

As Luka closes the distance between them, he says. "I just wanted to check that you didn't want to go home, Kerry said you might."

"Well I don't need to, and I'm not." Ray says, not giving anything away.

"Okay, what did Weaver want to talk to you about anyway?" Luka enquires.

Ray puts his hand behind his back to hide a severe cramp as he says. "Nothing important." Ray says, finding it all too easy to lie about his newfound illness.

"Alright then, I'll let you get back to your patients." Luka says as he starts to walk away, he then turns around, and says. "You know you can come to me if you need to talk?"

"Yeah." Ray replies, nodding, before going back to work.

* * *

Over the next six months Ray's condition continues to progress, unknown to his co-workers, and even to Neela, his roommate, he has a PEG tube surgically placed in his stomach, and has to use a bi-pap mask at night.

He manages to hide his condition at work, and function as normal until one fateful morning. Ray has been on shift for fourteen hours, and he can barely move as he gets ready to leave when the call comes in, there's been a mass casualty incident, all hands on deck.

* * *

As the trauma patients start rolling in, Ray is assigned to a critical patient. He and Sam take the patient into a trauma room, and they've barely begun the primary survey when Ray suddenly can't support himself, and he falls, directly onto the patient's fractured pelvis, just as Luka is walking into the room.

"What the hell are you doing, Ray?!" Luka demands as Sam helps Ray off the patient, and over to a stool.

Ray looks up weakly from where he is sitting. "I slipped."

"Go wait at the admit desk, I'll deal with you once we've handled all the traumas." Luka orders angrily.

Without comment, Ray shakily stands, and walks tentatively out of the room.

* * *

It is almost six hours later when Luka finally goes over to Ray, who as ordered is still sitting at the admit desk.

By now Ray is on the verge of collapse, and should probably be a patient, not a doctor.

Luka doesn't waste anytime in telling Ray. "Go home, Barnett. I'm suspending you until I can work out what to do."

This is the last straw for Ray, he has gone six months with no mistakes and now one little slip is going to ruin everything. "Don't bother. I quit!" Ray says angrily, cursing his slightly slurred speech as he does so.

Before Luka can say anything, Ray takes off as quickly as he can, and barely a moment later, Neela notices what's going on, and follows him.

* * *

Neela spots Ray just as she reaches the top of the EL platform stairs, and she couldn't be more shocked. At the moment she lays eyes on him, Ray jumps forward into the path of one of the fast moving trains, and she could swear that her heart stopped in that moment, but thankfully a couple of bystanders see what's happening, and pull him out of the trains path just seconds before it rushes through.

Neela puts her hand to her chest as she runs over to where Ray is now sitting between the two complete strangers who've just saved his life. "Ray!"

He barely even looks in her direction as she kneels down beside him.

"What is wrong with you?!" She demands still shaken.

Again, he says nothing.

Neela looks up at the two men, and asks. "Can you help me get him over to a bench? He's a friend of mine."

The men nod, and then promptly hoist Ray up between them, and half carry him over to the nearest bench. After Neela says her thanks, they walk away.

Neela then sits down beside Ray, and forces him to look at her as she repeats. "What is wrong with you?"

"Lemme 'lone, Neela." As soon as the words leave his mouth, Ray curses himself, she has heard him slur his speech.

Neela looks on the verge of tears as he says. "Are you alright, Ray? Please talk to me."

Ray takes a moment to calm himself before, almost coldly he says. "I am fine. Just leave me alone." He pauses, and then adds. "I am moving out of the apartment."

Neela nearly falls off the bench in shock. _Why is he doing this? It doesn't make any sense!_ "What?"

Ray doesn't reply, he takes a moment to prepare himself, and then stands up, and begins to walk away.

"Ray! Where are you going?! Come back here!" Neela yells at him as he walks towards the train, and climbs aboard, never looking back at her.

* * *

Several weeks later, Ray takes a taxi out of the city, to a small private hospice. He knows that his condition has reached a point where he can no longer take care of himself.

When he enters the centre, a kind looking older woman greets Ray from her position behind the reception desk. "Hello, how may I help you?"

Ray takes a deep breath, and lets it out with a sigh as he says. "I'm Ray Barnett, I've made arrangements to check in here."

* * *

**TBC...**

**Thanks for reading, I hope you enjoyed it!**

**Please let me know what you think!**


	4. Chapter 4

**Disclaimer: I don't own ER, or any characters you recognise.**

**Hi all! Thank you some much for all the wonderful reviews! This is the final chapter of this fic, I hope you've enjoyed reading it as much as I have writing it!**

**I was going to post this last night, but my internet is being a piece of ****! Thanks for your patience.**

**Just to make this clear - ****I have no medical knowledge, just way too much time to search the internet. Sorry for any inaccuracies.**

**Enjoy!**

* * *

It is three years before Ray returns to the ER, and no one is expecting it.

* * *

Neela is now a surgical attending, and due to a no show ER attending she is covering for the night shift. She is sitting tiredly at the admit desk with several other ER staffers, including Luka and Sam, when a call comes in over the MICN, Sam is quick to answer it. "County General."

A moment later the paramedic on the other end tells her. "We're bringing in an end stage ALS patient from Lakeside Hospice, difficulty breathing despite continuous bi-pap."

Sam sighs; they're already overstretched, and now they're going to spend the night keeping a terminal patient alive a bit longer, prolonging his pain. But none the less, she says. "What's your ETA?"

"We're pulling up now." Is the answer, and Sam, Neela and Luka rush out into the freezing night to meet the ambulance.

* * *

As Pickman and Zadro pull the gurney out of the back of the ambulance, Neela looks down at the patient as she asks the paramedics. "Do you have a name? He looks …familiar, maybe we've treated him before?"

For the first time in the run, Pickman actually takes the time to look at the chart given to her by the hospice, and as she does, her jaw drops, and she lets out a strangled cry. "Oh god."

They all look at her strangely, wondering what's going on. Zadro asks his partner. "Who is it Doris? What's going on?"

"His name's Dr Ray Barnett. He used to work here, right?"

"Ray?!?" Neela says, shocked as she leans over their patient, and sure enough, now she is really looking it is obvious to her, it's him, a lot thinner, weaker, but definitely him.

Luka takes control of the situation when it is clear to him that Neela can't. "Okay people, let's get him inside. Trauma two." He then looks down at Ray, and upon seeing that his eyes are open, Luka tells him. "It's alright, Ray. We're taking care of you."

* * *

Once they are in the trauma room, and initial vitals and labs have been done, Sam puts Ray's computer in front of him, giving him a means to communicate.

Luka asks her. "What's that for? There's no way he can type."

"It was sent in with him. There's a speech synthesiser program. You can try to find out his wishes, there's no DNR on file." Sam answers quickly before returning to her duties.

Luka and Neela sit down beside the gurney, and Luka starts of by asking a simple question. "Ray, do you know where you are?"

Ray blinks several times, and as soon as the computer starts a pre-programmed message, they know that he isn't lucid, his oxygen levels are too low.

While Neela stays at Ray's side, watching over him, Luka asks Sam. "Is there a next of kin to contact?"

Sam flicks through the file before she answers. "There's a pager number for his legal guardian, and a handwritten note to call his mother when he isn't expected to live more than a few more days."

Luka runs a hand through his hair. "Call both of them. Without a trach he probably won't live through the night."

Neela turns to them, and asks. "Well why aren't we doing a trach then? There's no DNR, we do everything we can."

Fair point, but. "You know how these cases go Neela. Very few patients actually want to prolong it by being put on a vent."

* * *

An hour later, Ray's stats have dropped to near non-existence, his guardian hasn't arrived, and Neela won't wait any longer. "We've got to trach him. We can't just watch him die!"

"I know, Neela." Luka reluctantly agrees before turning to Sam and ordering her gently. "Get a trach tray, and call RT for a vent."

* * *

By the time Kerry, Ray's legal guardian arrives from the airport, with Henry in tow, Neela has put in the trach, and Ray is connected to a ventilator.

She goes over to the desk, and nearly gives Frank another heart attack as she snaps loudly. "Frank."

Frank spins around, and looks at his former boss. "Dr Weaver? What're you-"

Kerry interrupts him by saying. "Where's Ray? Who's treating him?"

"Trauma two. Neela and Kovac just put him on a vent." Frank tells her, still slightly stunned by her reappearance.

Kerry swears under her breath, before she rushes towards the trauma rooms, pulling Henry behind her.

* * *

Neela is checking on Ray when Kerry comes through the doors at a near sprint, and demands. "What the hell are you doing?! He doesn't want this!"

Neela turns around, and looks at Weaver in shock as she says. "You knew?"

"Yes." Kerry says more softly, seeing the tears in her former colleague's eyes. "He got sick almost four years ago, asked for my help."

"Why didn't he tell me?" Neela says with a slightly hoarse voice.

Kerry sighs sadly as she says. "Ray didn't want to be a burden on you, he loved you. Look, I'm sorry but, why did you do a trach? He has an advanced directive. This is exactly what he didn't want."

Neela looks on the verge of tears as she says. "I didn't know. It wasn't in his chart."

Kerry mutters something that her son shouldn't ever hear her say, and then tells Neela. "The hospice has had a lot of new staff recently; these sorts of things keep happening …he didn't even want to be brought in." She pauses far a moment before she asks. "Please take him off the vent, this isn't what he wanted."

"His mother is on her way, once she arrives, and I see the papers, I will do it." Neela says sombrely, struggling to maintain some semblance of composure.

Kerry nods, and sits down beside Ray's gurney to wait.

* * *

Three hours later, the whole ER staff, everyone who knew Ray gathers in Trauma two as his mother arrives, and Neela prepares to disconnect the ventilator.

In the room, Neela looks to Kerry and Ray's mother for approval, and after seeing them nod, she injects a sedative to Ray's IV line before she turns to the ventilator, and shuts it off before turning back to Ray, and takes away the life persevering tubing.

Neela then kneels down slightly beside Ray, and runs her hand through his hair as she whispers "I love you, Ray. I'll never forget you." just as the monitors show a flat line.

Ray has died.

* * *

**The End.**

**Thanks for reading, I hope you enjoyed it!**

**I'd love to hear your thoughts on the final chapter!**


End file.
